Case Reports

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EBV+ B-cell polymorphic lymphoproliferative disorder of the lip in a patient with advanced chronic lymphocytic leukemia

Steven Townsend, Gabrielle Robinson, and Ben J. Friedman

Introduction: Polymorphic B-cell lymphoproliferative disorders (B-LPDs) are a rare, morphologically heterogeneous, and diagnostically challenging group of neoplasms that occur in the setting of immunosuppression. Associated lesions are almost uniformly Epstein-Barr virus-positive (EBV+) and can cause destructive masses that may mimic more aggressive lymphomas. Clinical outcomes are highly variable, ranging from resolution with withdrawal of immunosuppression to fatal dissemination of disease.

Clinical case: A 77-year-old white male with a history... Read More
Adenocarcinoma of the Ethmoid Sinus Presenting with Epiphora

Matthew R. Tukel, Geoffrey J. Gladstone, and Colin Appleford

Abstract: Low-grade non-intestinal type adenocarcinomas are rare tumors that arise from the surface epithelium of the sinonasal tract. They frequently involve the ethmoid sinus, the nasal cavity, and the maxillary sinus. These tumors present at a mean age range of 37-53 years with various non-specific symptoms including nasal obstruction and epistaxis. We report the first case of a low-grade non-intestinal type sinonasal-adenocarcinoma of the ethmoid sinus presenting with persistent... Read More
Early Onset Angiosarcoma of the Breast Following Breast Conserving Therapy

Elizabeth Ulrich, Jessica Bensenhaver, S. David Nathanson, and Lindsay Petersen

Introduction: Breast angiosarcoma following treatment for breast cancer is a rare event and generally presents no earlier than 6 years after treatment. We identified 2 cases of early-onset angiosarcoma and evaluated patient and treatment factors.

Methods: At our large multi-hospital health system, the tumor registry was searched for breast sarcoma from 2000-2020. Patient, tumor, and treatment details were collected.

Results: 39 patients were identified, 4 with radiation induced angiosarcoma... Read More
Evans Syndrome in Pregnancy: A Case Report

Gayathri Vadlamudi and Madhurima Keerthy

Evans syndrome is a chronic autoimmune disease characterized by autoimmune hemolytic anemia (AIHA) along with immune thrombocytopenic purpura (ITP), caused by autoantibodies against red blood cells and platelets. The prevalence of ITP alone is 12/100,000 in U.S. adults, and Evans syndrome has been diagnosed in 1.8-10% of patients with ITP. Few case reports of Evans syndrome in pregnancy have been published, and guidelines for treatment are not well-defined due... Read More
Campylobacter jejuni bacteremia in the setting of pancytopenia

Natalie M. Wiseman and Andrew Failla

Introduction: Campylobacter species are a common infectious cause of acute diarrhea worldwide. Small gram-negative bacteria, Campylobacter species are commonly transmitted fecal-orally and frequently found nonpathogenically in the guts of animals including chickens, creating a risk for frequent animal-human transmission. Campylobacter jejuni, one of the most important Campylobacter species for human health, typically produces a watery or inflammatory diarrhea. It is common in developing countries and outbreaks are often linked... Read More
Leptospirosis: A tropical disease in the Midwest

Joshua J. Won

Introduction: Regional diseases travel across the globe with little difficulty in the modern age. Ease of long-distance travel and importation of exotic goods are the culprit. Leptospirosis is a disease mostly prevalent in tropical countries surrounding the equator, with the incidence of new cases decreasing as you move north. It is a zoonotic disease, with rodents as the common host, contributing to about 900,000 cases worldwide with up to... Read More
A Painful Protrusion – A Rare Presentation of Appendicitis

Allen Wrubel, Adam Heilala, and Jason Kramer

Introduction: Acute appendicitis is a common presenting clinical pathology and imaging diagnosis in everyday practice, as well as indication for surgery. CT is a sensitive first line imaging modality for assessing for appendicitis. Often assessed with ultrasound given the benefit of dynamic maneuvers, hernias are also commonly incidentally noted on CT.

Methods: Portal venous phase CT is a sensitive first line imaging modality in assessing abdominal pain and appendicitis... Read More
A Case of Metastatic Squamous Cell Carcinoma in a Patient with Recessive Dystrophic Epidermolysis Bullosa that was Responsive to Pembrolizumab, a Programmed Cell Death Protein 1 Inhibitor

Danielle Yeager, Molly Powers, and David M. Ozog

A case of metastatic squamous cell carcinoma in a patient with recessive dystrophic epidermolysis bullosa that was responsive to pembrolizumab, a programmed cell death protein 1 inhibitor.

Purpose: Cutaneous squamous cell carcinomas (SCCs) are the leading cause of death in patients with recessive dystrophic epidermolysis bullosa (RDEB). Management of SCCs in these patients is challenging with higher rates of recurrence and lymph nodes metastases. Although surgery is the first-line... Read More
Metastatic squamous cell carcinoma in a RDEB patient treated with pembrolizumab

Danielle Yeager, Molly Powers, and David M. Ozog

A case of metastatic squamous cell carcinoma in a patient with recessive dystrophic epidermolysis bullosa that was responsive to pembrolizumab, a programmed cell death protein 1 inhibitor.

Purpose: Cutaneous squamous cell carcinomas (SCCs) are the leading cause of death in patients with recessive dystrophic epidermolysis bullosa (RDEB). Management of SCCs in these patients is challenging with higher rates of recurrence and lymph nodes metastases. Although surgery is the first-line... Read More
Plummer-Vinson Syndrome

Samer Zakhour and Raya B. Kenana

A 37-year-old African American woman with no past medical history presented to the Emergency Department with a chief complaint of abdominal pain. She also reported associated fatigue and dysphagia. Over the past two months, she reported 40 Lbs. unintentional weight loss and decrease appetite. Her dysphagia primarily to solids, which also had been worsening over the past few weeks. She had no history of similar symptoms in the past.... Read More
Congenital Midline Nodules on the Chin and Sternum

Allison Zarbo, Kevin M. Luk, Tor Shwayder, and Ben J. Friedman

History: A 5-day old black male full-term neonate born via vacuum-assisted delivery for non-reassuring fetal heart rate presented with congenital presentation of two asymptomatic midline lesions which appeared asymptomatic. There was no history of seizures, ophthalmologic findings, abnormalities in head circumference, height, weight or limb size. Newborn screening examination was unremarkable.

Examination: On the midline submental chin there was a soft, brown dome-shaped plaque measuring 0.8-centimeters with a circumferential... Read More